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Monday, July 5, 2010

Well...gang, as always it seems I posted too quickly and didn't REALLY think through EVERYTHING I wanted to share about traveling with Type 1. No worries... this would have been too long for one post anyhow.

So...

I found these two pics from our trip to Disney World a couple of years ago. I forgot to mention to you "PUMPERS" out there that a "special" screening in the Airport Security Area is par for the course. So definitely plan on more time upfront to get checked-in and to your gate. Not only does Joe always set off the alarms, but he is then wanded, patted down, his backpack (filled with Bakugan, books, and usually his Nintendo DSI, and rocks - oh those damn rocks) is gone through by Security Personnel, and his hands are dusted or wiped for analysis (of what I am not sure, but I think some sort of explosive powder residue perhaps - or maybe that is my over-D-R-A-M-A-T-I-C brain coming up with that).

Also, CARRY ON....and I repeat CARRY ON EVERYTHING when it comes to Diabetes Supplies. You don't know where you can get stuck or what can happen. I haven't received any guff about carrying on insulin, EMLA Cream (a big tube), needles, sets, etc. I have a physicians letter stating Joe's diagnosis of type 1 diabetes and his need for access to his diabetes supplies at all times. I have not, to this date, needed the letter at all during travel. I do like that I have it just "in case".

With the above being said, the Security Personnel at the airports we have been through have been phenomenal. They have been surprised at how good Joe is about the screening - he totally knows what to expect and just "assumes the position" (see above).

Anyway...just one Security Lady in all of our years with "D" has pissed me off. I was traveling solo with Bridget and Joe about 2 1/2 years ago to visit my brand new niece. We had been held up in Burlington International for 2 hours due to snow in NY. We finally arrive in NY (LaGuardia - GOD I HATE that airport) and have to schlep to another concourse. At LaGuardia you have to either wait for some shuttle that never seems to MATERIALIZE or WALK OUTSIDE next to an insane amount of traffic. On this particular day, in February, the WALK is in a BLIZZARD. You can see where this is headed; we WALKED, well more like I "cattle-prodded" my entourage ... picture in your mind Joe (4), Bridget (5), and I ...without coats (I checked them, because how could I possibly manage the bulky coats in addition to "D" supplies, the two children, and our other carry on items I ask you?), one of the two children was wearing Crocs (hello B-L-I-Z-Z-A-R-D), and to top it all off, one child was crying uncontrollably because he/she had to pee (hint: it is the other child...not the one who had to take the "emergency piss" landing in Seattle in Ashamed of Feeling Shame). So, I (while trying not to strangle Bridget and Joe's cute little necks that support their heads which don their even CUTER faces) somehow get us: me - (the CRAZY MOM, multiple bag carrying pack mule, trying to get her little ones from point A to point B without jumping in front of a taxi to put myself out of my misery); Bridget - (the crying, Croc-wearing, bladder about to explode sensing daughter); and Joe - (the non-stop body moving machine who could use a "LOW preventing, body-binding velcro suit" type 1 son) to the desired concourse that seemed to be at least a MILE away. But alas WE MADE IT (we always do).

First off...the pee issue (ALWAYS the pee issue FIRST), I high-tail Bridget, still crying, to the bathroom. I then discover that I need to "re-check" in for our next flight - WTF? So, as you must know, that means ANOTHER line (ALWAYS the lines). Whatever... it is all good.

We then get the "added bonus" of going through security AGAIN - fine. So, I send my two kids through the metal detector first. Bridget - no ringing, good. Joe - I try to let the lady know that he always rings it off due to his insulin pump. I could tell right away this lady was all business, somewhat miserable in her life or job, her face is stone and she wants NOTHING to do with the likes of smiling, trying to be "helpful" me. So, she ignores me, and has Joe come through the metal detector - BEEP, BEEP, BEEP - yeah, no shit. Nope, she still WON'T listen to me (face is still stone-like and NO eye contact) and makes Joe go through the metal detector AGAIN - OK lady, you wanna play that way? well, Joe no "likey". Joe is 4 years old for this trip mind you and he is now confused because usually he is immediately ushered to the area where the airport personnel wand you and pat you down. So he comes back to me to go through the metal detector again, but is now a little nervous and DOES NOT want to go anywhere near this COLD FISH of a human being. This lady says "COME ON KID, GET GOING"... Joe is still standing there a little put off by her harsh tone. I then encourage him to go through the metal detecting arch and I then let the woman know that he is a 4 year old and to take it EASY. She then responds to me "I know LADY, I have had a 4 year old too you know" - UGH. Anyhow, that is truly the only negative experience I have encountered and it really wasn't even all "D"-related, just an unhappy, "pinched puss" face, nasty middle-aged woman who didn't know how to deal with young kids... ANNOYING.

Well what ended up being even more annoying was we MISSED the flight from New York to Texas and waited in stand-by for 5 different planes before heading to Texas. Yes, sweet peeps that means I was stranded SOLO with Bridget (5), Joe (4), and "DIABETES" (yep, sometimes I consider "D" a 3rd child) for 9...N-I-N-E HOURS before we finally got a connecting flight. This reinforces the need to CARRY ON ALL "D" SUPPLIES... I REPEAT... CARRY ON ALL "D" SUPPLIES.

OK...now I feel I have adequately shared my travel experiences to date with you AWESOME"D-RENTS". Another tale of what the day-in-the-life is truly like.

POST EDIT: One more thing to be aware of - I know for our Animas Ping we are instructed in the manual to turn of the RF Communication between the Pump and the Glucometer. I am not sure what other Pump Companies recommend. I cannot find anything in the DexCom Users Guide on shutting down the CGM for flying. We have flown with it on without any "adverse" flying events - i.e. no crashes or emergency landings due to equipment malfunction - smiles.

Sunday, July 4, 2010

So, I have noticed a trend with my last couple of posts...TRAVEL. Yep they were both AIRPLANE HORROR STORIES and yes The Maher Clan survived with all 4 members alive and well with senses of humor intact...and with their desire for adventure strong.

It has been almost 4 years since Joe was diagnosed with type 1. In that time period we have flown several times and a couple of times I have flown solo with Bridget and Joe. We have also enjoyed several road trips in the New England area. I feel I have had some "interesting" experiences and am now a veteran packer and "diabetes preparer". The thing is, ANYTHING can happen while on the road or in flight and it is important to be prepared. Type 1 can be quite UNFORGIVING at times.

So here is a list of what I pack and reasons why:

FIRST OFF - BRING DOUBLE OF EVERYTHING

1) TWO vials of INSULIN - why 2 you ask? Well, what if you lose one? I thought of this as I became a member of the MILE HIGH CLUB. We were flying across country with one vial of insulin (STUPID, yes) and I was changing Joe's pump site while in flight. What if we hit turbulence and the vial fell off my lap and was lost under the plethora of feet, baggage, personal belongings etc. on the airplane floor. That made me SUPER NERVOUS...so ALWAYS 2 vials.

2) TWO TIMES the BLOOD SUGAR TEST STRIPS that you would normally use in the time you are going to be away - You could end up with a bad test strip batch and with this much extra you should be fine. Secondly, on vacation you are eating different foods and doing different activities than normal...which requires MORE BLOOD SUGAR TESTING.

3) FOR PUMPERS - twice the amount of SETS AND CARTRIDGES - Especially the sets. When we vacation, there is frequently swimming involved and WATER + LIFE SAVING DEVICES THAT DEPEND ON ADHESIVE = DO NOT MIX. So be prepared....extra sets for sure, then this is a NON-ISSUE.

4) EXTRA IV 3000 (AGAIN, for pumpers) - This thin transparent dressing is a "lifesaver" for "site-saving" while swimming. I didn't have enough when we visited Disney World in the Spring and briefly thought of holding Joe back from swimming to his heart's content...then reminded myself that "D" won't get in the way of Joe being a "kid" - so I ended up changing out his site an extra time or so.

5) Blood Ketone Monitor with test strips AND Urine Ketone dip sticks... double preparation is key...you never know when an unwanted "Vomit Bug" (and yes, I acknowledge that there IS NOT a WANTED "VOMIT BUG") may visit or when site failures may be aplenty.

6) Obviously, pack double the sugar and extra snacks for travel. A different schedule and foods will affect different people in different ways.

7) AN EXTRA BLOOD GLUCOSE MONITOR - OK this one is SERIOUS and the following is a TRUE story. It happened to us 2 summers ago while on a road trip:

We were spending the night in New Hampshire in the middle of B.F.E. (might as well have been). Dave goes to check Joe at midnight. The glucometer does not register a number. We try a different strip - NADA. The glucometer was registering the code number and saying apply blood, but then after the blood was applied, NOTHING would happen - NO countdown and NO number. We then tried a different test strip vial - it won't calibrate. We then change the batteries...re-check Joe - still NO NUMBER. The glucometer is BROKEN... AND IT IS MIDNIGHT AND WE ARE IN THE MIDDLE OF B.F.E. .... SHIT. So, we then get out the yellow pages and start calling the 3 pharmacies listed - none are open until 8am the next morning. We did find a hospital that was like a 2 hour drive away (4 hours round trip), but by the time that whole scenario played out we might as well just stay put and buy the glucometer when the local pharmacy opened. So, after phone calls dialed, no where to go in the wee hours of the morning, and after much deliberation....here is how we handled this LESS THAN OPTIMAL SITUATION - I checked Joe for ketones at 1a.m. He had NO Ketones. So, since I didn't know if he was high, low, or whatever...I decided to give him 2 glucose tablets to "boost" him in case if he was low. Around 4 a.m. we checked Joe to make sure he was still breathing...then thank goodness he woke up ALIVE at 6 a.m.-ish.

That was one of the scariest nights of my life to date. I had NO idea what his number was. I only knew he had no ketones. So, I figured the safest thing to do was to give him a little sugar in case if he was low and HOPE for the best. So people ALWAYS TWO BLOOD GLUCOSE MONITORs...ALWAYS.*Other points to NOTERemember to pack extra batteries for the glucometer and the pump (for pumpers).

With the glucometer calibration fluid, slowly, and I mean S-L-O-W-L-Y people, twist off the lid after flying - I have had that red crap spray all over me when opening the lid too quickly after the depressurizing from a flight.

PUMP SETTINGS - figure out what works for you or your little one...once you have traveled a few times you will start to notice a blood sugar pattern on "travel days". Joe usually runs HIGH on travel days due to inactivity of his crazy, normally over-active self. So, I usually crank Joe's basal up by 50% or so on flight days (or on a "drive day")...and I also give an extra 10-20% Insulin with each bolus to keep his numbers somewhat in range. Each person is different, but this seems to be what works for us.